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Individual

DR. ALFRED MONTAGUE LAND IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10928 EAGLE RIVER RD, SUITE 250, EAGLE RIVER, AK 99577-8038
(907) 696-4987
Mailing address
951 E BOGARD RD, SUITE 203, WASILLA, AK 99654-7175
(907) 376-2456

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1275
AK
1223G0001X
General Practice Dentistry
D9151
OR

Other

Enumeration date
09/03/2008
Last updated
02/15/2012
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